IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI No. In the matter of U Incapacitated/Disabled Person u GUARDIAN'S ANNUAL REPORT I/We, , Guardian/Co-Guardians of the above named ward submit the following information as required pursuant to the provisions of 475.082 R.S. Mo 1985.u The present address of the ward is My/Our present address is During the past year I/We contacted the ward The nature and description of my/our contacts with the ward ­u u .u Date I/we last saw the ward was The ward is currently institutionalized in .u u times. .u .u _____________________________________________________________. (If not institutionalized, so state.) As Guardian/Co-Guardians have you received a copy of the treatment or rehabilitation plan? Yes _____ No _____. Do you agree with its provisions? Yes _____ No _____. The date the ward was last seen by a physician is visit by a physician was ­ . The purpose of the .u I/We have observed the following major physical or mental conditions of the ward (if none, so state): _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ For Court's Use Only: KSTAT ­ Status/Annl Report Filing KOSTR ­ Order Approving Status Report CCPR003 Rev. 10/13 American LegalNet, Inc. www.FormsWorkFlow.com I/We feel that the continuation of the guardianship is/is not needed for the following reasons: u ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ My/Our opinion as to the adequacy of the care of the ward is as follows: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________. My/Our opinion as to the facility where the ward is as follows: _______________________________________________________________________________________ _______________________________________________________________________________________. Comments:u U U U .U Return To: St. Louis County Probate Court 7900 Carondelet, Fifth Floor Clayton, MO 63105 Signed this day of , 20 u U Signature of Guardian/Co-Guardians U Typed Name of Guardian/Co-Guardians u Street Address u City State Telephone Number Zip Code u CCPR003 Rev. 10/13 American LegalNet, Inc. www.FormsWorkFlow.com